Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

urinary > presentation of diseases of the kidney and urinary tract > Flashcards

presentation of diseases of the kidney and urinary tract Flashcards

1
Q

What are the parts of the upper urinary tract

A

Kidneys and ureters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is part of the lower urinary tract

A

Below the ureters e.g bladder and urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do renal diseases present

A

Pain
Pyrexia
Haematuria
Proteinuria
Pyuria - sign of inflammation which is caused by infection
Mass on palpation
Renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the definition of proteinuria

A

Excreting more than 150mg of protein in urine per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many types of haematuria are there and what are they

A

3:
Microscopic
Macroscopic
Dipstick haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the definition of microscopic haematuria

A

More than 3 blood cells per high power field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is oliguria

A

low urine output - <0.5mg/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is relative anuria

A

Urine output less than 100ml per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is absolute anuria

A

No urine output per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is polyuria

A

Excess urine output - >3L per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is nocturia

A

Waking up more than once in the night to micturate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is nocturnal polyuria

A

The urine output in the night is greater than 1/3 of the total daily urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is micturition less common in the night

A

Because ADH production is increased which causes more reabsorption of water so less volume of urine to be excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do we use to define acute kidney disease in terms of staging

A

R - risk
I - injury
F - failure
L - loss
E - end-stage kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe R in ‘RIFLE’ for AKI

A

R- risk - increase in serum creatinine x1.5 or decrease in GFR by 25%. or urine output less than 0.5ml/kg/hour for 6 hours (oliguria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe I in ‘RIFLE’ for AKI

A

Injury - increase in serum creatinine x2 or decrease in GFR by 50% or oliguria 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe F in ‘RIFLE’ for AKI

A

Failure - increase in serum creatinine x3 - decrease in GFR by 75& or urine output less than 0.3mg/kg/hour or anuria for 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe L in ‘RIFLE’ for AKI

A

Loss - persistent acute renal failure or complete loss of kidney function for more than 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe E in ‘RIFLE’ for AKI

A

End-stage kidney disease - complete loss of kidney function for more than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Presentation of chronic renal failure

A

Asymptomatic
Tired
anaemic
oedema
High Bp
Bone pain due to renal bone disease
Pruritus - unpleasant feeling making you want to scratch
Nausea/vomiting
Dyspnoea
Neuropathy
Coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do infections cause at the ureters

A

Ureteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are Iatrogenic causes of ureteric diseases

A

Ureters are close to the GI so can be cut during surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What kind of cancers are in the urinary system

A

Transitional cell carcinoma (carcinoma of the uroepithelium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are hereditary issues associated with the ureters

A

PUJ obstruction - pelvic ureteric junction obstruction

VUJ - vesiculo-ureteric junction

25
Q

What are the presentations of ureteric diseases

A

Pain
Pyrexia
Haematuria
Palpable mass
Renal failure - only if bilateral obstruction or one kidney is functioning

26
Q

What do infections of the bladder cause

A

Cystitis

27
Q
A
28
Q

What are the common types of neoplasia for cancer

A

Transitional cell cancer of the bladder or squamous cell carcinoma

29
Q

How do bladder diseases present

A

Pain (suprapubic)
Pyrexia
Haematuria
Lower urinary tract symptoms
Recurrent UTI
Chronic urinary retention
Pneumaturia - air bubbles - connection to the bowel

30
Q

What are storage LUTS

A

Frequency, nocturia, urgency and can cause urge incontinence
Related to bladder function

31
Q

What are voiding LUTS

A

Poor flow, intermittency, terminal dribbling
Related to obstruction

32
Q

What is the risk of bladder cancer in a patient with macroscopic (visible) haematuria

A

25-30%

33
Q

What is the risk of renal cancer in a patient who presents with macroscopic (visible) haematuria

A

0.5-1%

34
Q

What are symptoms of the bladder

A

Lower urinary tract symptoms (LUTS) - voiding LUTS, storage LUTS, incontinence, polyuria…

35
Q

What are the 3 levels of neurological causes of bladder issues

A

Supra-pontine lesions (above the pons) - caused by stroke, alzheimers…
Infra-pontine supra-sacral lesion - e.g spinal cord injury
Infra-sacral - e.g MS, cauda equina

36
Q

What part of the brain is known as the micturition centre

A

The pons

37
Q

How is micturition controlled

A

Cortical centre - bladder sensation and conscious inhibition of micturition
Then the Pons (micturition centre)
Then the sacral segments (S2-4) - micturition reflex
Micturition cycle: storage (filling) phase and voiding phase

38
Q

describe the micturition reflex

A

Sympathetic nerves cause relaxation of the internal urethral sphincter

Relaxation of the external urethral sphincter is voluntary

Contraction of the detrusor muscle is controlled by sympathetic nerves

39
Q

What is balantis

A

Inflammation of the glans (head of the penis)

40
Q

What are presentations of the bladder outflow tract diseases

A

Pain (suprapubic or perineal)
Pyrexia
haematuria
LUTS
Recurrent UTI
Acute or chronic urinary retention

41
Q

What usually causes voiding LUTS (hesitancy, intermittency, poor flow, terminal dribbling, incomplete emptying of the bladder)

A

BOO - Bladder outflow obstruction

42
Q

Define acute urinary retention

A

Painful inability to void with a palpable and percussible bladder

43
Q

What is the main risk factor for acute urinary retention

A

BPO - benign prostate obstruction

44
Q

What is the immediate treatment of acute urinary retention

A

Catheterisation

45
Q

Define chronic urinary retention

A

Painless, palpable and percussible bladder after voiding

46
Q

What is the main factor which can cause chronic urinary retention

A

Detrusor underactivity

47
Q

how does chronic urinary retention present

A

LUTS or complications like UTI, bladder stones or renal failure

48
Q

How does obstruction cause chronic urinary retention

A

Obstruction means the bladder has to pump harder to push urine out through the urethra past the obstruction and overtime this weakens the bladder

49
Q

When do you give treatments to patients with chronic urinary retention

A

If they have symptoms or complications

50
Q

What is the immediate treatment of chronic urinary retention and then subsequent treatment

A

immediate treatment is catheterisation - but can put at risk of UTI

Subsequent treatment is long term urethral or suprapubic catheter but CISC or TURP if due to BPO

51
Q

What is TURP

A

Trans-urethral resection of prostate

52
Q

How is the prostate meant to look on a cystoscope

A

The prostate should look like an open tunnel

53
Q

What is the difference between complicated and uncomplicated UTI’S

A

Uncomplicated UTI - young sexually active female with clear relation to sexual activity

Complicated UTI - everything else

54
Q

What is required to diagnose a UTI

A

Microbiological evidence and symptoms/signs

55
Q

What symptoms do you need at least one of to diagnose UTI with microbiology

A

Fever>38 , flank pain, suprapubic pain, urinary frequency, urgency and dysuria

56
Q

What are complications of UTI

A

Sepisis
Renal failure
Bladder malignancy
Acute urinary retention
Frank (visible) haematuria
calculi

57
Q

What investigations are done for patients with UTI

A

MSSU
Flow studies, cystoscopy
USS - ultrasound scan , IVU/CT-KUB - kidneys, ureters and bladder

58
Q

What is the treatment for UTI

A

Appropriate antibiotic therapy

59
Q
A

urinary (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions